ACE gene rs4343 polymorphism elevates the risk of preeclampsia in pregnant women.

The multifactorial basis of preeclampsia (PE) implies that there are several genes and risk factors that are important in the development of the disease. Therefore, the exact etiology and pathogenesis of preeclampsia remains unclear. It is suggested that inappropriate regulation of the renin-angiotensin system (RAS) is a risk factor for hypertension during pregnancy. The angiotensin I-converting enzyme (ACE) serum level, a key component of the RAS, affects the blood pressure. It is hypothesized that the ACE gene polymorphisms contribute to preeclampsia development. In a case-control study containing 296 subjects (165 PE patients and 131 normotensive controls), we aimed to examine the association of the ACE gene I/D and rs4343 polymorphisms with preeclampsia in Iranian women. Genotyping for rs4343 and ACE I/D polymorphisms was performed by using TP-ARMS-PCR and conventional PCR, respectively. The rs4343 G allele frequency was higher in the case group (OR = 1.90, 95% CI, 1.37-2.65; P = 0.0001). Besides, a significant difference was detected for the genotype frequencies between the studied groups under dominant (OR = 3.94, 95% CI, 2.05-7.56; P  < 0.0001) and recessive (OR = 2.21, 95% CI, 1.22-4.01; P = 0.009) inheritance models. For the I/D polymorphism, no significant differences were detected in the genotype and allele frequencies or any of the inheritance models between PE patients and controls. To verify the current results and validate the significance of the studied genetic variations, additional studies in diverse ethnic populations are required.